Otitis Externa (OE) commonly called Swimmer’s Ear, is an inflammation of the lining of the external auditory canal. It has been reported to occur five times more often in swimmers than in non-swimmers. Although rarely lifethreatening, swimmer’s ear is painful and often curtails the individual’s water activities. A variety of prescription and non-prescription products are available for both the prevention and treatment of swimmer’s ear.
Swimming, diving, exposure to high humidity and showering promote retention of water in the inner canal. The moisture that accumulates dilutes a protective acid mantle in the ear and this creates a favorable environment for growth of bacteria. Normally, bacteria do not multiply in the inner two-thirds of the auditory canal although they are present in safe numbers in about 70 percent of normal individuals.
Aquatic activities increase the chances for moisture to enter this area of the canal, which, in turn, encourages proliferation of bacteria. Initial signs and symptoms of swimmer’s ear are often present hours or even days after swimming or exposure to increased moisture.
Symptoms are itching and mild to moderate pain in the ear canal. Affected people often complain that the ear canal feels wet and full. The pain is worsened when pressure is applied around the external auditory meatus, the ear lobe is pulled, or the jaw is rocked from side to side.
The presence of an ear discharge, elevated temperature, tiredness or combinations of these indicate the presence of a bacterial infection.
Otic (ear) preparations containing acidifying and drying agents are effective for both the prevention and treatment of swimmer’s ear. Usually, improvement occurs immediately after alcohol-acetic acid solutions are started in the early stages. Oil-based suspensions should be avoided as these products may actually plug the canal rather than clean it of debris. Once an infection has developed, the addition of antibiotic prescription ear drops such as Colistin and Neomycin are effective in treating swimmer’s ear.
Attempts to clean the ear canal by using a cotton-tipped applicator may force cerumendebris plugs more deeply into the canal as well as traumatize the canal lining. This further exposes the canal lining to moisture, micro-organisms, inflammation and infection. Severe infections also require oral antibiotics by prescription. Analgesics are used for pain, acetaminophen and anti-inflammatory drugs help reduce canal edema and pain.
Probably the most significant advances in the treatment of swimmer’s ear have occurred by prevention. Individuals who do a lot of swimming should take specific measures to prevent swimmer’s ear. Measures to prevent moisture retention are the prime consideration.
Mechanically, this can be done by vigorously shaking the head or jumping with the head tilted to one side and then the other. Fanning the ear canal opening also has a drying effect. It is a common practice for competitive swimmers to use non-prescription ear drops containing 2.75 percent boric acid in isopropyl alcohol (Swim Ear), for the prevention of ear canal infections. Usually, 3 to 6 drops are instilled in each ear canal after swimming.
Some children and adults use ear plugs when swimming to keep water out of the ear canal which is fine except that the application of pertroleum jelly to these plugs as an effort to create a, watertight seal (as in the care of children with ear tubes) is not recommended. This tends to accumulate debris and moisture in the ear canal.
Following these precautions to prevent and treat swimmer’s ear will make your summer fun more enjoyable.